By Paige Barrella, Citlalli Florez, and Rena Abdusalam
WOODLAND, CA – Dr. Juliana Rohrer, an expert in psychology and competency, testified Friday at a competency trial in Yolo County Superior Court that she diagnosed the man accused of a series of stabbings in Davis, CA, with schizophrenia. The trial began earlier this week and will reconvene Monday.
Carlos Reales Dominguez was a University of California, Davis, sophomore studying biology when he was arrested for allegedly stabbing three individuals on separate occasions in Davis, resulting in two deaths and one hospitalization.
The results of this jury trial will determine whether Dominguez is competent to stand trial for murder.
Among the evidence Dr. Rohrer said she relied on to form her conclusion about Dominguez’s mental state is an email from Dominguez’s attorney, Deputy Public Defender Daniel Hutchinson.
In this email, Hutchinson expresses concern about Dominguez’s mental state and physical appearance stating, “He appears to be aware of the charges against him, but he has no insight whatsoever of the seriousness and the gravity of his case.”
Dr. Rohrer expanded on this, reading further from the email, “[Dominguez] makes comments suggesting that he may believe he will be released soon.”
“In your opinion is that a description of a person who can assist his attorney, in a rational manner, in asserting a defense?” inquired Hutchinson following the reading of the email. “No, it is not,” responded Dr. Rohrer.
Dr. Rohrer also testified to her personal observations of Dominguez during her interviews with him, noting the accused has difficulty articulating, not responding or doing so with few words, and does not usually make eye contact with individuals unless directed to do so.
On one occasion of questioning, the witness said, Dominguez abruptly got up, put on his jacket, and approached the door to the room as if going to leave. When asked by officers where he was going, he responded that he was just going for a walk.
The fact that Dominguez seems not to understand his current situation was cited by Dr. Rohrer as a factor in her diagnosis.
In the examination of Dr. Rohrer, she was shown a video from an earlier court proceeding where Dominguez stated, “I want to apologize and I want to say I’m guilty,” while making eye contact with the judge.
Deputy District Attorney Matthew P. De Moura questioned Dr. Rohrer about whether this clip of Dominguez was consistent with her previous testimony and report findings.
The doctor responded that she was unsure and would need to ask more questions. When asked if Dominguez’s statements indicated that he understood that his guilt or innocence was at issue in the court proceedings, Dr. Rohrer replied, “It could, but it also couldn’t.”
She went on to explain, “I’m not sure if he’s saying that statement because he’s responding to delusional thoughts or if he’s saying it because he wants a lesser sentence or for something else to happen.”
Dr. Rohrer eventually testified that many of the symptoms exhibited by Dominguez could “go either way,” in that they could indicate schizophrenia or they could indicate neurotypical behavior.
On Friday, the trial started with one of the jury members having to be replaced by an alternate because of private personal issues. A new juror was placed on the stand. The former jury member is still bound to not discuss the case.
The first witness was the accused’s nurse, who referred to a note written by a doctor which Dominguez began seeing after he was arrested. The physician recommended anti-psychotic medication instead of alternative routes.
The nurse admitted that she did not want to give Dominguez the medication because she did not believe that he qualified to legally take the medication. He didn’t “meet the criteria,” according to policy and procedure, she said, adding she was also not aware of any other laws which could be used for Dominguez to be able to have the medication administered on an emergency basis.
The witness also claimed that the recommendation was more of a thought and that many doctors write down their thoughts, but it wasn’t an order. She also stated that many attempts to communicate with the doctor about the issues regarding the prescription failed.
“We wanted to make sure that we found a way to provide this medication and still be able to stay within the letter of the law… we do what we need to do to give this patient a community standard of care,” said the nurse.
It wasn’t until later that Dominguez was able to take the medication. According to the witness, this was also due to delays caused by the accused being in jail at the time.
A second witness, also a medical professional, stated Dominguez showed symptoms of schizophrenia and tests showed signs of mental deterioration. He said the accused’s grades and behavior in high school were above average and he had a normal IQ, suggested from analyzing an old SAT score. When the accused went to university, his grades dropped, and a recent IQ test showed his score was lower.
Before the incidents, Dominguez would allegedly tell his girlfriend and roommates he had delusions and would often reference the devil. He would also have signs of paranoia and state that there were people who would speak badly of him. These symptoms aligned with schizophrenia.
Although signs weren’t present in high school, the doctor concluded that it’s very possible that the disease developed during his time at UC Davis.
Contrary to what the nurse stated in regard to his eating habits, it was noted Dominguez was very thin when first arrested. The nurse said, although she did not know what he was eating, he was indeed eating which prompted her not to believe that the medication guidelines were met.
The prosecution then called Dr. Timothy MacDonald, a psychiatrist who briefly met Dominguez at Woodland Memorial Hospital for a requested consultation. MacDonald’s psychiatric consultation notes were provided as an exhibit.
On May 22 of this year, MacDonald was contacted by emergency room staff to conduct an assessment regarding Dominguez’s qualifications for a 5150 psychiatric hold. Dominguez was in custody at the time and was being treated for pneumothorax.
MacDonald began to describe his assessment, relying heavily on his consultation notes, describing that Dominguez was a “young, lean male” that looked his age, had “limited speech,” appeared “distracted” and made “some eye contact.”
MacDonald reported Dominguez’s mood was “euthymic with a congruent affect,” was very focused on something unrelated and that his thought process was “concrete, but appropriate.”
According to MacDonald’s notes, Dominguez denied all mental health symptoms including “suicidal or homicidal ideations” and “auditory or visual hallucinations.” Dominguez expressed no interest in psychiatric treatment.
“I documented that the patient does not show any overt signs of psychosis or mania,” MacDonald said, adding, “He does demonstrate an interest in food and water, but has no appetite.”
In his testimony, MacDonald provided a caveat, noting, “Due to the limited nature of the engagement, I documented that my insight and judgment were limited at that time.”
MacDonald concluded, “At that time, the patient appeared to be overwhelmed by life events and was not eating or drinking, but [appeared] to be open to it with encouragement. And at that time, there was not an indication to maintain the patient on a 5150, which is a psychiatric hold for a psychiatric diagnosis. So involuntary hospitalization was not indicated.”
He added, “Potentially, I suggested the patient should consider a trial of a low-dose of antidepressants.”
Deputy District Attorney Frits P. Van Der Hoek seized on one of MacDonald’s comments, asking, “When people are in custody, facing serious charges, can that be an overwhelming life event?” MacDonald simply responded, “Yes.”
DDA Van Der Hoek then asked MacDonald about the qualifications for a 5150 psychiatric hold, and MacDonald explained the 5150 evaluation depends on whether the patient poses a risk to themself or others and whether the patient is able to care for themself.
“And your conclusion was that [Dominguez] was not a danger to himself, danger to others, and that he was able to care for himself?” questioned DDA Van Der Hoek.
“At that time,” MacDonald replied uneasily.
DDA Van Der Hoek closed his initial examination by asking if Dr. MacDonald cares less about patients that are in custody. MacDonald rejected that idea.
During cross-examination, MacDonald admitted that he had a vague recollection of the consultation.
When DPD Hutchinson asked if MacDonald was aware of the crimes Dominguez had been charged with, the witness noted he became aware around the time of consultation, but couldn’t remember if it was before or after.
DPD Hutchinson pressed, “But you did know that he was an inmate from Yolo County Jail?” and MacDonald answered, “Yes.”
DPD Hutchinson then challenged how conclusive MacDonald’s assessment could be. He questioned the importance of Dominguez denying symptoms of mental illness, asking, “But you know, from your experience as a psychiatrist, that it is not uncommon for people who are mentally ill to deny symptoms?” MacDonald seemed uncomfortable with the premise, noting, “It really depends on the symptom.”
DPD Hutchinson also commented on MacDonald’s notes on Dominguez’s appetite, asking if the psychiatrist had any knowledge about the amount of time since Dominguez last ate.
“There was a notation in the summary from the ER staff that noted it had been up to five days of possibly not eating or drinking,” MacDonald replied.
The DPD continued to interrogate how valuable MacDonald’s assessment could be given the circumstances at the time of the consultation, asking how MacDonald could determine whether the patient is able to care for themself while “his basic necessities were being provided for him” by the Yolo County Jail.
“But, you knew that he had his basic necessities provided for him at the jail?” asked DPD Hutchinson. “My question is if you have a person come in, and one person is from a jail and has people give him food, shelter, and clothing, and the other person is homeless on the street with no one providing that, do you consider that in whether a 5150 hold is appropriate?”
“Maybe to a certain extent. But, a patient can still starve, even in jail,” replied the psychiatrist.
Hutchinson agreed, “Yes, they can,” wrapping up the defense’s cross-examination.
